BCBS Expands Blue Distinction Health Insurance To 800 Facilities

Health insurance behemoth Blue Cross Blue Shield announced today that it is expanding its Blue Distinction program to include centers that provide excellent care in spine surgeries and knee and hip replacement. Blue Cross provides health insurance to millions on Americans nationwide. The announcement comes on the day of Obama’s State of the Union which is likely to address health care reform in some fashion or another.

Blue Cross’s Distinction designation is essentially a gold star handed out to Blue Cross and Blue Shield companies that have shown stellar performance and provided top quality health care. The program was designed to help customers in choosing the right facilities when special care such as treatment for cancer, or a heart transplant is needed.

With the addition of spine surgery and knee and hip replacement centers to the fold, Blue Cross’s official Distinction designation list has now grown to six. The other centers include bariatric surgery, cardiac care, complex and rare cancers, and finally, transplants. The centers are located in 46 states and in Washington D.C.. They number 1,600 in total.

Blue Cross determines which facilities deserve the designation through a fairly rigorous process that includes reviews, physician’s opinions and proprietary advice from leading medical centers. In other words, when certain criteria set by the insurance company are met, they give out the designation.

This, of course, begs the question: will this specially approved facility actually cover those who need it? Will their Blue Cross health insurance help or hurt? Moreover, what kind of premiums, and deductibles do members have to pay? The fine print of the press release states that there already may be other “Blue companies” that offer spine, hip and knee surgery. These supposedly do not interfere with Blue Distinction companies.

If so, do customers with access to Blue companies not on the list default their access to Distinction facilities? Will they have to pay even more? Is this the Zagat rating of medical care or the Michelin? Indeed, Blue Cross guarantees that their standards for the rating are not lax or bias, however, alliances are not uncommon in the health care industry.

Facilities that have thus far not reached Distinction status are routinely reviewed and given feedback on how they can better their care quality. Blue Cross aims to improve health care across the board by setting up a standard of care. This in turn gives patients more access to better treatment and care.

Whether patients without Blue Cross Blue Shield as their health insurance provider are left out is not explicitly addressed in the press release. As Blue Cross is one of the largest health insurance providers out there, it would seem that patients without it or any insurance at all would be left in the cold.

With president Obama’s upcoming speech on health care and the economy, it should be interesting to see the outcome on health insurance and the health industry as a whole. Blue Cross Blue Shield will likely have to dig into their own pocketbooks should health care reform become a reality.

Written by Lani Shadduck

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Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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